Cytomorphological Spectrum of Hepatic Nodular Lesions A Tertiary Care Centre Experience
Cytomorphological Spectrum of Hepatic Nodular Lesions
Keywords:
FNAC, Liver, Nodular, Hepatic, NoduleAbstract
offers good accuracy without major complications and minimal intervention at less cost, the only major contraindication being severe hemorrhage & vascular lesion. Although imaging techniques have helped greatly with the early and accurate diagnosis of liver abscess, the appearances are often non-specific. There is some overlap between the radiologic features of liver abscesses, HCC and metastases too. Tumors, primary or secondary, may undergo extensive necrosis, with the resultant radiologic image of the cavitatory neoplasm mimicking abscesses; abscesses are accompanied by proliferative reactive changes, making radiologic differentiation from a neoplastic process almost impossible. In these situations, FNAC plays an essential complementary role. Material and Methods: All patients, irrespective of age and sex, who presented to the hospital from January 2011 to June 2013 with nodular liver lesions diagnosed clinically or radiologically, with normal range of prothrombin time (International normalized ratio- INR) were subjected to fine needle aspiration under radiological guidance. Smears made were stained with toluidine blue for rapid onsite evaluation (ROSE) for adequacy of diagnostic material. Hematoxylin and Eosin (H&E), Giemsa stain and Papanicolaou stain were done as per protocol. Results: Of the total aspirates, 22.5% (36 cases) were benign, 63.75%(102) were malignant, 13.75% (22) non-representative as they contained only few scattered hepatocytes and blood, which was inadequate for final opinion. FNAC was of help in diagnosing liver lesions successfully in 86.25% of cases. Conclusion: USG guided FNAC has proved to be a fairly precise & minimally invasive technique in diagnosis of hepatic lesions as the procedure is simple, economical and easily available. The results are obtained quickly without serious complications related to the procedure. In a nutshell, FNAC is a highly accurate diagnostic tool with high sensitivity & specificity. [Selhi P NJIRM 2015; 6(1):57-61]
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